Choice Of Access Research Articles

Concurrent validity and test reliability of the deep learning markerless motion capture system during the overhead squat

Marker-based optical motion capture systems have been used as a cardinal vehicle to probe and understand the underpinning mechanism of human posture and movement, but it is time-consuming for complex and delicate data acquisition and analysis, labor-intensive with highly trained operators. To mitigate such inherent issues, we developed an accurate and usable (5-min data collection and processing) deep-learning-based 3-Dimensional markerless motion capture system called “Ergo”, designed for use in ecological digital healthcare environments. We investigated the concurrent validity and the test–retest reliability of the Ergo system measurement’s whole body joint kinematics (time series joint angles and peak joint angles) data by comparing it with a standard marker-based motion capture system recorded during an overhead squat movement. The Ergo system demonstrated excellent agreement for time series joint angles (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^{2}$$\\end{document} = 0.88–0.99) and for peak joint angles (ICC2,1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ICC_{2,1}$$\\end{document} = 0.75–1.0) when compared with the gold standard marker-based motion capture system. Additionally, we observed high test-retest reliability (ICC3,1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ICC_{3,1}$$\\end{document} = 0.92–0.99). In conclusion, the deep learning-based markerless Ergo motion capture system considerably shows comparable performance with the Gold Standard marker-based motion capture system measurements in the concurrent accuracy, reliability, thereby making it a highly accessible choice for diverse universal users and ecological industries or environments.

TELOMERE LENGTH IN RHESUS MACAQUES WITH VOLUNTARY CHRONIC ETHANOL CONSUMPTION

Introduction. Alcohol abuse is associated with telomere shortening. There is no convincing evidence of a “safe” level of alcohol consumption in this regard. Long-term studies in rodents are not feasible, and clinical trials with the administration of alcohol to healthy individuals is not ethically acceptable. An approach based on a relevant model of voluntary alcohol consumption in monkeys under controlled conditions is a significant alternative. The aim of the study. To estimate the length of telomeres at long-term ethanol consumption by male rhesus macaques in under free choice with water Methods. The study was performed on fourteen mature male Rhesus macaques of groups with low (median 0.62 g/kg/day) and high (median 2.71 g/kg/day) ethanol consumption as 4% (v./v.) solution with condition of all-day access and free choice with drinking water. The duration of consumption was 920 days. The relative length of telomeres was determined by quantitative PCR according to Cawthon (2002) in blood leukocytes. Results. The relative average telomere length in the high-consumption group was 1.53±0.57 before the presentation of ethanol in the adaptation period (-32 day of the study), and at the consumption stage it was on 717 day 2.13±0.19 and on 917 day 4.61±0.7. In the low-consumption group, the average relative telomere length constituted 1.42±0.22, 1.55±0.15 and 3.3±0.47, respectively. The absolute count of leukocytes did not change significantly during the study. However, changes in the differential white cells count were revealed representing development of relative monocytosis by 917 day in both groups. Conclusion. The data obtained do not confirm the association of long-term alcohol consumption in moderate doses with telomere length. The completed study has limitations related to the lack of control without consumption and evaluation in one sex.

Prevalence and Center Variability of Catheter-Based Hemodialysis in Vienna: Insights from the Vienna ACTS NOW Study.

Objectives: The choice of vascular access continues to be a critical component in the management of hemodialysis patients. Despite the international consensus favoring arteriovenous (AV) fistulas, the use of central venous catheters (CVCs) remains prevalent, with substantial variations across countries and even among dialysis centers within the same region. This study examines the prevalence of CVC use among chronic hemodialysis (CHD) patients in Vienna, Austria, and explores inter-center differences. Methods: A cross-sectional analysis was conducted on patients receiving CVC-based CHD in Vienna as of March 2023. Patient demographics, comorbidities and their hemodialysis history were collected. Additionally, a subset of the population underwent vascular access (VA) mapping to assess eligibility for AV fistula (AVF) or AV graft (AVG) creation. Results: A total of 335 patients received CVC-based hemodialysis, equaling a CVC proportion of 42.5%. 191 (57.0%) patients on CVC-based CHD gave their consent to record their clinical data and vascular access history. Of the 191 included patients, 61 gave their consent to receive VA mapping. Of the 61 patients who received VA mapping, 60 (98.4%) were eligible for an upper extremity AVF or AVG. There was no significant difference regarding patient demographics, dialysis vintage, history of previous AVF or AVG or Charlson Comorbidity Index between the mapping and non-mapping group. The odds ratio of having a CVC in the absence of in-house vascular surgery was 3.41 (95% CI: 2.31-5.02, p-value < 0.001) compared to patients with in-house vascular surgery. Conclusions: The majority of patients that consented to ultrasound VA mapping fulfilled vascular requirements for AVF or AVG creation. Our study highlights the potential to decrease the prevalence of CVC-based CHD in Vienna that could translate to a reduction in CVC-associated complications.

A case report on the choice of venous access after ectopic peripherally inserted central catheter in an upper limb of a patient with a second recurrence of right-side breast cancer.

Intravenous catheter placement in the healthy upper extremity is preferred for chemotherapy in patients with breast cancer. Common venous accesses are peripherally inserted central catheters (PICCs) and totally implantable intravenous port catheters (TIVPs). In this case, a patient with breast cancer had a history of infusion port placement through the left internal jugular vein, with ipsilateral innominate vein stenosis after placement. The patient was re-treated with a PICC placed ectopically through the left upper limb into the intrathoracic vein. After multidisciplinary consultation, a transfemoral PICC combined with intracavitary electrocardiography (IC-ECG) was performed to establish venous access. This case can assist PICC catheterization nurses in developing optimal venous access strategies tailored to the specific situations of patients in similar situations. Through adequate evaluations and optimal selection of venous access, the success rate of disposable catheterization can be improved, and the risk of complications reduced. A 53-year-old female with breast cancer had a history of infusion port, with ipsilateral innominate vein stenosis after placement. The patient was re-treated with a PICC placed ectopically through the left upper limb into the intrathoracic vein. An axial computed tomography (CT) image before totally implantable venous access port (TIVP) placement and An axial CT 103 days after TIVP placement shows diffuse stenosis of the left innominate vein, associated with infusion port placement through the left internal jugular vein. After multidisciplinary consultation, a transfemoral PICC combined with intracavitary electrocardiography (IC-ECG) was performed to establish venous access. The patient's lower limb PICC was left in place for 201 days with no complications, completing the full treatment cycle. This case presents a rare and insightful clinical scenario. For patients with a history of infusion port placement, particularly via the left internal jugular vein, careful analysis of the innominate vena cava and examination of chest wall vein exposure are essential to determining the optimal vascular access strategy.

Acute Ischemic Stroke during Extracorporeal Membrane Oxygenation (ECMO): A Narrative Review of the Literature

Ischemic stroke (IS) is a severe complication and leading cause of mortality in patients under extracorporeal membrane oxygenation (ECMO). The aim of our narrative review is to summarize the existing evidence and provide a deep examination of the diagnosis and treatment of acute ischemic stroke patients undergoing ECMO support. The incidence rate of ISs is estimated to be between 1 and 8%, while the mortality rate ranges from 44 to 76%, depending on several factors, including ECMO type, duration of support and patient characteristics. Several mechanisms leading to ISs during ECMO have been identified, with thromboembolic events and cerebral hypoperfusion being the most common causes. However, considering that most of the ECMO patients are severely ill or under sedation, stroke symptoms are often underdiagnosed. Multimodal monitoring and daily clinical assessment could be useful preventive techniques. Early recognition of neurological deficits is of paramount importance for prompt therapeutic interventions. All ECMO patients with suspected strokes should immediately receive brain computed tomography (CT) and CT angiography (CTA) for the identification of large vessel occlusion (LVO) and assessment of collateral blood flow. CT perfusion (CTP) can further assist in the detection of viable tissue (penumbra), especially in cases of strokes of unknown onset. Catheter angiography is required to confirm LVO detected on CTA. Intravenous thrombolytic therapy is usually contraindicated in ECMO as most patients are on active anticoagulation treatment. Therefore, mechanical thrombectomy is the preferred treatment option in cases where there is evidence of LVO. The choice of the arterial vascular access used to perform mechanical thrombectomy should be discussed between interventional radiologists and an ECMO team. Anticoagulation management during the acute phase of IS should be individualized after the thromboembolic risk has been carefully balanced against hemorrhagic risk. A multidisciplinary approach is essential for the optimal management of ISs in patients treated with ECMO.

Navigating the online food environment: policy pathways for promoting food access, transparency, and healthy food choices online.

The internet is drastically changing how U.S. consumers shop for groceries, order food from restaurants, and interact with food marketing. There is an urgent need for new policies to help ensure that the internet is a force for good when it comes to food access, transparency, and nutrition. This article outlines actions that federal agencies-like the U.S. Department of Agriculture (USDA), U.S. Food and Drug Administration (FDA), and Federal Trade Commission (FTC)-and state and local governments can take to improve the online food environment. We recommend policies in three settings: online grocery retail, online restaurant ordering, and marketing on social media and other online platforms. For example, USDA could finalize regulations increasing access to online WIC and remove barriers to accessing online SNAP by requiring large retailers to waive online delivery and service fees for SNAP purchases. FDA could improve access to nutrition information by issuing guidance describing what product information should be available at the online point of selection. FTC could give better guidance on appropriate tactics when marketing to children and collect better data on how companies are marketing food to children online. Finally, state governments could pass laws like New York's recently introduced Predatory Marketing Prevention Act to address false and misleading advertising of unhealthy foods aimed at children and other vulnerable groups.

Rare forms of ectopic pregnancy in the rudimentary horn and ovary. How not to miss the main thing?

This article presents two cases of ectopic pregnancy in the ovary and rudimentary horn, which had a life-threatening course. Despite availability of modern high-quality diagnostics, determining the condition remains challenging, because the definitive diagnosis is established and confirmed only intraoperatively. Hence, the clinical picture can be used primarily in making a diagnosis and choosing an appropriate treatment strategy. Rare localizations, such as in the ovary and rudimentary horn, which cause difficulties in making a diagnosis, should not be overlooked. If an ectopic pregnancy is not detected promptly and the risks are underestimated, death may occur. Two clinical cases clearly demonstrate timely diagnosis, regardless of additional examination methods (e.g., pelvic ultrasound, human chorionic gonadotropin test), and adequate choice of access and scope of surgical intervention. Moreover, the lack of awareness among women about this type of pathology should be considered. Patients often do not complain, do not remember the date of their last menstruation, do not monitor their menstrual cycle, and do not seek medical help in a timely manner. The combination of several factors can lead to fatal events. In this study, both cases of ectopic pregnancy with a rare localization ended favorably.

Comparative Study between One Year Patency of Brachio- Basilic Arteriovenous Fistula versus Brachial to Basilic Forearm Loop Graft in End Stage Renal Disease Patients

Abstract Background Autogenous arteriovenous fistula (AVF) is considered the first choice for vascular access. Transposed arteriovenous fistulas include transposed brachial-basilic arteriovenous fistulas and transposed brachial-brachial arteriovenous fistulas, both basilic vein and brachial vein are too deep to cannulate, so requires transposition to be accessible. Aim of the Work to compare the outcomes of patients treated with a Brachio-basilic arteriovenous fistula with those of patients treated with the polytetrafluorethylene (PTFE) brachial to basalic loop graft. Methods This prospective cohort observational study included 50 patients with end stage renal disease (ESRD) on regular hemodialysis who were divided into two equal groups; group A: included patients who underwent the Basilica forarm polyteterafloruracil arteriovenous graft (BBAVG) and group B: included patients who underwent Basilic vein transposition or basilic vein superficialization (BBAVF). Results There was no statistically significant difference between the two studied groups regarding age, gender, clinical characteristics, primary, assisted primary or secondary patency rates, functional maturity at 1, 3, and 6 months, early postoperative bleeding (p = 0.312), late postoperative bleeding (p = 1), early postoperative mortality (p = 1), thrombosis (p = 0.018), late postoperative thrombosis (p = 0.157), early postoperative mild Infection (p = 0.123), early postoperative sever infection (p = 1), late postoperative mild infection (p = 0.074) and late postoperative sever infection (p = 0.297). Conclusions Both BBAVF and PTFE brachial to basilic loop graft can be considered as viable options for vascular access in this patient population. The choice of procedure may depend on individual patient factors, as well as the risk of thrombosis, which should be carefully evaluated.

Modern approaches and technologies to prevent anastomotic leakage in the gastrointestinal tract

The healing of gastrointestinal anastomoses is acomplex biological process influenced by numerous factors. Various strategies to support healing and prevent anastomotic leakage (AL) exist, encompassing preoperative, intraoperative and postoperative measures. Preoperative interventions aim to optimize the patient and the tissue environment, particularly the gut microbiome. Intraoperative measures are technical in nature and include the choice of surgical access, the anastomotic technique and anastomotic reinforcement. Various procedures of the intraoperative diagnostics enable identification of such anastomoses requiring additional protective measures. Recently, indocyanine green (ICG) fluoroscopy has become established for evaluation of tissue perfusion, while newer techniques such as spectral microscopy offer promising possibilities. Postoperative diagnostic methods aim to identify potential AL as early as possible to enable initiation of therapeutic steps even before the onset of symptoms. These procedures range from various imaging techniques to innovative bioresorbable, pH-sensitive implants for early AL detection. Due to the multifactorial genesis of AL and the diverse technical possibilities, no single method will become established for prevention of AL. Instead, acombination of measures will ultimately lead to optimal anastomotic healing. The use of artificial intelligence and analyses based on the data promises a better interpretation of the vast amount of data and therefore to be able to provide general recommendations.

Surgical access route and choice of implant in the region of the clavicle shaft

Clavicle fractures are among the most frequent injuries of the shoulder girdle. Nondisplaced fractures are generally treated conservatively, whereas dislocated fractures require surgical reduction and stabilization. A variety of implants and surgical techniques with reliable results are available. While all techniques provide similar healing rates, they share acommon disadvantage with the high incidence of implant irritation and correspondingly high rates of second interventions for material removal. The various surgical techniques for clavicle shaft fractures with their specific areas of application as well as advantages and disadvantages are presented. This review also provides an aid for deciding which surgical technique is most appropriate based on the fracture morphology. Furthermore, an overview of current research activities is presented, with aspecific focus on new implants which could help to reduce implant irritation. Open superior and anteroinferior plate osteosyntheses each show similar reliable results. The minimally invasive plate osteosynthesis (MIPO) technique offers an alternative for multifragmented fractures as it has alower complication rate compared to the open procedure. Double plate osteosynthesis using minifragment plates shows promising results with respect to the incidence of implant-related irritation. Larger prospective studies are still pending. Intramedullary nailing offers agood alternative, especially if material removal is planned anyway, e.g., in the pediatric setting.

Placement of tunneled hemodialysis catheters - interventional standard.

While the native arterio-venous fistula (AVF) remains the first choice in vascular access for most hemodialysis patients, tunneled hemodialysis catheters (tHDC) continue to be an option in selected patients. Since timely access to vascular surgery-due to delayed referral or resource limitations-is not always possible, nephrologists have to become more actively involved in planning, creation and monitoring of vascular access. Moreover, this approach could also strengthen patient-centered care in nephrology. This manuscript reviews the current standard in tHDC creation, patient selection and strategies to mitigate the risk of infectious complications and catheter thrombosis. Presentation of novel developments in catheter placement with ultrasound-guided or ECG-guided positioning, their benefits and possible disadvantages emphasizes the complexity of vascular access planning. We offer an approach for choice of insertion method, depending on selected side and existing resources and set focus on the necessity and required resources of 'interventional nephrology' training programs.

Patient Experience and Satisfaction with Orthopedic Services at a Community (Rural) Setting Hospital-How Is It Different from Urban Setting.

Patient experience and satisfaction are the keystones in evaluating the effectiveness of clinical care in musculoskeletal medicine. Although all orthopedic settings work on the same principles of providing safe and quality health care, community hospitals represent a unique environment. There may be key differences with regard to patient experience between these settings. Accessibility to care, choices of provider, personalized care, availability of and access to resources, cultural and social variances, and waiting times are a few of the many elements that may impact patient experience and satisfaction. This narrative review aims to explore the core differences in these settings and how they can reflect on patient experience and satisfaction.

Strong third-order nonlinearity in amorphous silicon carbide waveguides.

Silicon carbide (SiC) photonic integrated platform has attracted significant research interest for on-chip optical applications, owing to its exceptional optical properties such as a broad transparency window, high refractive index, and strong nonlinearity. Among the various types of SiC, amorphous SiC (a-SiC) has particularly emerged as an accessible choice for forming thin-film SiC-on-insulator (SiCOI) stacks, demonstrating promising capabilities for wafer-scale photonic applications. In this work, we prepare three a-SiCOI samples using the plasma-enhanced chemical vapor deposition, with different refractive indices. We fabricate optical waveguides, conduct four-wave mixing measurements, and characterize the nonlinear refractive index in these samples. Our findings reveal that an increase in the refractive index of a-SiC leads to a corresponding increase in the nonlinear refractive index, which is comparable to that of silicon. Hence, a-SiC offers an approach to develop a SiC platform with a wider bandgap than that of silicon, minimizing two-photon absorption while also providing a higher refractive index and stronger nonlinearity compared to crystalline SiC.

Recommended for You: Explicit Motivations and Recommender Systems Influence Users’ Media Engagement and Well-Being

People are inundated with readily accessible entertainment media choices. Recommender systems are frequently utilized to support people's media selection and engagement. The psychological factors that influence people's engagement with recommender systems and entertainment content is an under-explored area. This paper reports the findings of an exploratory study where users’ explicit experiences of audiovisual media services (e.g., Netflix, TikTok, YouTube, HBO Max) and their recommender systems were examined through an online survey (n = 339). Thematic analysis, factor analysis, and path analysis were used to evaluate the data. The results indicate that (1) recommender systems influence users’ emotions and media use, (2) people prefer personalized compared to generic recommendation lists, (3) the temporal length of recommended content influences people's interest, and (4) perceived utility leads to the endorsement of recommender systems and may influence users’ well-being. The findings point to wider psychological implications associated with user awareness of recommender systems.

PyChelator: a Python-based Colab and web application for metal chelator calculations

BackgroundMetal ions play vital roles in regulating various biological systems, making it essential to control the concentration of free metal ions in solutions during experimental procedures. Several software applications exist for estimating the concentration of free metals in the presence of chelators, with MaxChelator being the easily accessible choice in this domain. This work aimed at developing a Python version of the software with arbitrary precision calculations, extensive new features, and a user-friendly interface to calculate the free metal ions.ResultsWe introduce the open-source PyChelator web application and the Python-based Google Colaboratory notebook, PyChelator Colab. Key features aim to improve the user experience of metal chelator calculations including input in smaller units, selection among stability constants, input of user-defined constants, and convenient download of all results in Excel format. These features were implemented in Python language by employing Google Colab, facilitating the incorporation of the calculator into other Python-based pipelines and inviting the contributions from the community of Python-using scientists for further enhancements. Arbitrary-precision arithmetic was employed by using the built-in Decimal module to obtain the most accurate results and to avoid rounding errors. No notable differences were observed compared to the results obtained from the PyChelator web application. However, comparison of different sources of stability constants showed substantial differences among them.ConclusionsPyChelator is a user-friendly metal and chelator calculator that provides a platform for further development. It is provided as an interactive web application, freely available for use at https://amrutelab.github.io/PyChelator, and as a Python-based Google Colaboratory notebook at https://colab.research.google.com/github/AmruteLab/PyChelator/blob/main/PyChelator_Colab.ipynb.

Housing-Resources Spatial Mismatch Investigation of Affordable Housing and Policy Implementation: A Case Study from Hangzhou, China

Intensive spatial transformation and restructuring in China these years has brought the separation of residence-job, so as to residence-public services, which adversely affects people’s access and enjoyment of job and public service resources, especially for the disadvantaged populations with limited choice of residence location and insufficient access to those resources. The residents of affordable housing are among the typical disadvantaged populations under the existing affordable housing policy in China. Residence-job separation of affordable housing residents has been paid much attention in literature, but no specific study has been conducted on the residence-public services separation and the behavioral responses of the residents. Spatial mismatch theory was originally put forward to reveal the adverse labor market outcome brought about by residence-job separation, and nowadays some scholars have tried to extend the residence-job spatial mismatch to residence-other resource spatial mismatch. This research responds to both the dilemma facing by the disadvantaged affordable housing residents and the extension trend of spatial mismatch theory. By applying the spatial mismatch theory and taking several affordable housing communities of Hangzhou as examples, the study explore the problems existing in affordable housing in commuting, employment, public service and residents&amp;apos; behavior response. The results found that the current affordable housing policy has led to an increase in commuting costs, a decrease in employment accessibility and welfare, a decrease in accessibility and satisfaction of public services, and disruptive behavior in the affordable housing market. These problems are mainly caused by remote layout and single supply, unreasonable allocation methods, difficulty in exchanging housing units and inadequate supervision of undesirable behaviors. To alleviate the spatial mismatch between housing and resources in Hangzhou, policy suggestions could be considered from four aspects: housing layout and supply, allocation methods, housing exchange and supervision.

International subjects on the periphery: the publishing challenges of early-career female academics from Central and Eastern Europe

PurposeThe paper’s aim is to explore female academics’ publication aspirations and constraints in a less researched area of Central and Eastern Europe (CEE).Design/methodology/approachThe research data presented in this paper is part of a larger cross-European project involving semi-structured interviews conducted with Early Career Researchers (ECR) (PhD+ 8 years) from Social Sciences and Humanities (SSH) from seventeen European countries.FindingsThe findings show how ECR women from the CEE region in SSH encounter difficulties when trying to publish, which obstacles add to a strong economic and geopolitical dependence. Findings reveal that female ECRs use various publications strategies to enhance their scientific career and engage in the neoliberal model of academia, but mostly stay in their local scientific communities, without building internationally recognized scientific careers. Thus, they do wish for a global recognition, but they opt for a safer and more accessible choice of publishing in their local scientific communities.Originality/valueKnowledge which academic women from the CEE region produce (mostly in their local languages) stays in their local and isolated enviroments, creating an imbalanced knowledge advancement in a international academic arena which recognizes only publications written in English and in renowed journals.

ОЦЕНКА РЕЗУЛЬТАТОВ ПРИМЕНЕНИЯ АЛГОРИТМА ВЫБОРА ОПТИМАЛЬНОГО ХИРУРГИЧЕСКОГО ДОСТУПА К ЗАБРЮШИННОМУ ПРОСТРАНСТВУ У ПАЦИЕНТОВ С РАЗЛИЧНЫМИ ПАРАМЕТРАМИ КОНСТИТУЦИИ.

Relevance. Despite the rapid development and predominance of endovideosurgical techniques in the treatment of pathologies of organs and structures of the retroperitoneal space, the implementation of transperitoneal or retroperitoneal approaches for open surgical interventions remains a routine activity. Surgical treatment of various pathologies of retroperitoneal localization leads to the development of nonspecific life-threatening complications in 23.8% - 30% of clinical observations, and associated mortality - 7.2% - 11% of cases. Previously, our works presented the results of comparing the number of this type of complications when using laparotomy or retroperitoneal access, depending on the constitutional parameters of the patient. An assessment was made of the significance of the influence of constitutional parameters on the development of nonspecific life-threatening complications, on the basis of which an algorithm for choosing the optimal surgical access to the structures of the retroperitoneal space was developed [patent application No. 2024113445 dated May 17, 2024]. Purpose of the study. To evaluate the effectiveness of using an algorithm for selecting the optimal surgical approach in the surgical treatment of pathologies of organs and structures of retroperitoneal localization. Materials and methods. Comparative analysis of the results of surgical treatment of patients with various surgical pathologies of the retroperitoneal space. Group I (n = 167), where the choice of surgical approach was determined using the “optimal surgical approach selection algorithm.” Group II (n = 284), in which the choice of access to the structures of the retroperitoneal space was not unified and was chosen without taking into account the constitutional parameters of the patient. In the perioperative period, the duration of surgical intervention, the volume of intraoperative blood loss, the number of days of stay in the intensive care unit, the time of postoperative respiratory support, the duration of postoperative intestinal paresis and the number of postoperative bed days were assessed. Criteria assessed in the postoperative period: development of myocardial infarction, acute cardiovascular failure, ARDS with the development of respiratory failure, acute kidney injury; cases of development of ischemic colitis and small intestinal obstruction, requiring repeated interventions, as well as the phenomenon of multiple organ failure. Wound complications included failure of retroperitoneal and laparotomy wounds, including eventration. To calculate quantitative characteristics, the median (Me) and percentiles (Q0.25 - Q0.75) were determined. Calculation of statistical significance between groups was performed using the Mann-Whitney U test**, for comparison of qualitative indicators - the Chi-square test* in IBM SPSS Statistics 25 software. Results. In group I, compared with group II, there was a shorter surgical intervention time [140.8 vs 179.5] min, p = 0.031**, a smaller volume of intraoperative blood loss [280.4 vs 413.3] ml, p = 0.024* *; postoperative respiratory support [4.5 vs 8.5] hours, p = 0.041**; length of stay in the intensive care unit [1.8 vs 3.4] days, p = 0.021**; postoperative intestinal paresis [1.2 vs 4.8] days p = 0.024**; and duration of total postoperative hospital stay [9.1 vs 16.4] days p = 0.003**. The number of postoperative nonspecific life-threatening and wound complications in group I was 24 (14.4%), and in group II - 64 (22.5%) cases (p = 0.023*). The number of complications-related deaths in group I was 9 (5.4%); in group II - 32 (11.26%) cases (p = 0.037*). Conclusion. The use of an algorithm for selecting the optimal surgical approach for surgical treatment of pathologies of organs and structures of the retroperitoneal localization of the access leads to a reduction in the number of nonspecific life-threatening complications to 14.4%, and associated deaths to 5.4%.

La configuración de las ciudades emergentes: Una revisión a la sintaxis espacial

This review focuses on the phenomenon of spatial syntax from the perspective of urban performance, through its theoretical evolution applied in the scenario of intermediate cities, allowing to understand the role of accessibility and the urban built environment, for the improvement in the provision of services from the instruments of planning and management of the territory. In the development of this research, various data sources such as Scopus, Scielo, Research Gate and Google Scholar were used, structuring the theoretical basis with various articles from journals indexed in Atlas.ti that, under the inductive method, allowed the triangulation and identification of co-occurrences in the different cases. The review concludes that, the analysis of spatial syntax and its components, define how performance is important for the diagnosis of urban sectors, since, it provides information for decision making from public action such as accessibility and angular choice, which constitute urban integration.

The pediatric DAV-expert algorithm: A GAVeCeLT/GAVePed consensus for the choice of the most appropriate venous access device in children

In pediatric patients, the choice of the venous access device currently relies upon the operator’s experience and preference and on the local availability of specific resources and technologies. Though, considering the limited options for venous access in children if compared to adults, such clinical choice has a great critical relevance and should preferably be based on the best available evidence. Though some algorithms have been published over the last 5 years, none of them seems fully satisfactory and useful in clinical practice. Thus, the GAVePed—which is the pediatric interest group of the most important Italian group on venous access, GAVeCeLT—has developed a national consensus about the choice of the venous access device in children. After a systematic review of the available evidence, the panel of the consensus (which included Italian experts with documented competence in this area) has provided structured recommendations answering 10 key questions regarding the choice of venous access both in emergency and in elective situations, both in the hospitalized and in the non-hospitalized child. Only statements reaching a complete agreement were included in the final recommendations. All recommendations were also structured as a simple visual algorithm, so as to be easily translated into clinical practice.